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Call to quarantine 'superbug' patients

ELEANOR HALL: An Australian infectious diseases expert says many travellers who return home with an infection should be put into medical isolation.

Dr Lindsay Grayson says increasing numbers of Australian travellers are presenting at hospitals infected with antibiotic resistant "superbugs" and he says it's time for hospitals to take the problem more seriously, as Simon Lauder reports.

SIMON LAUDER: The head of infectious diseases at Melbourne's Austin Hospital says the need for hospitals to isolate superbugs is increasingly urgent.

LINDSAY GRAYSON: We don't have a lot of time to fuddle around with bureaucracy here and things are happening fast. We have probably two or three years before we will be facing the same issues as many parts of Europe and we've to get our act together quickly, and I think we need to move on this faster than is currently taking place.

SIMON LAUDER: For Dr Lindsay Grayson the urgency was highlighted by the case of a 66-year-old man who had returned to Melbourne from Greece, where he had been treated for a bowel condition and picked up an infection in the process.

LINDSAY GRAYSON: The problem was that his bugs were so difficult to treat and we had to make a decision - very complex surgery, remove the infected part of the bowel, stop the source of the superbugs, if you like - and eventually, after a number of months of rehabilitation, he's recovered fully and back home.

SIMON LAUDER: A subsequent review of similar cases found 10 other patients who were infected with multi-drug resistant organisms had also returned from overseas in the six months before admission.

Dr Grayson says he now believes that all hospitals should put high risk patients into quarantine.

LINDSAY GRAYSON: We've now instituted a policy that any returned travellers who come to our hospital who'd need medical care, we assume that they're contaminated until we can confirm that they're not. We now put them into lockdown isolation until we've confirmed that they're not carrying superbugs.

SIMON LAUDER: So, they're virtually quarantined?

LINDSAY GRAYSON: Oh, absolutely, yes. That's exactly what we're doing, and I guess the point of our article is to say, well, we now feel that for many hospitals around the country, this change in thinking, this assumption that these patients should be quarantined until they are proved to be safe, in our view, is the way I think we will now need to start practicing medicine, and of course this has a lot of implications.

Firstly, it means that where we're needing the single rooms for these patients, whereas otherwise we're usually desperately short of single rooms, we would have used them for other patients.

SIMON LAUDER: Is it dangerous for hospitals to admit these patients without such protocol, if they're just in the general ward?

LINDSAY GRAYSON: Oh well potentially, yes.

SIMON LAUDER: Is there any requirement for hospitals to notify authorities when they admit patients who have a superbug?

LINDSAY GRAYSON: No there isn't, and we have a long list of other diseases where we must tell the Health Department that we've isolated a certain bug - you know, gonorrhoea, or syphilis, or anthrax, these sort of things.

But these superbugs are actually causing much more trouble than many of these bugs that are already on the notifiable list, and for some of them, there's three or four which are just so dangerous, if they were to get into the hospital and are so well-adapted to spreading within the hospital, despite all the cleaning and all the rest, that I think they should become notifiable.

So when you ask me next time for an interview, how common are these superbugs, we should be able to say, well, in the last year there were X number of admissions with this. At the moment, we could not do that.

SIMON LAUDER: The group which represents public hospitals says while putting patients into quarantine would help stop the spread of superbugs, it's not always an option for many hospitals. Alison Verhoeven is the chief executive of the Australian Healthcare and Hospitals Association.

ALISON VERHOEVEN: That would put enormous pressure, obviously, on the hospital system. We know that nationwide the national average for single rooms in hospitals in Australia is around 25 per cent of the hospital being single rooms.

So we do know that blanket admissions of all ill travellers into quarantine facilities in hospitals would put significant pressure on the system.

SIMON LAUDER: Dr Grayson's warning and his recommendations appear in an article in the latest edition of the Medical Journal of Australia.